Treatment of Sensitive Areas for Registered Massage Therapists

As of September 11, 2017, the College of Massage Therapists of Ontario (“CMTO”) amended its Standard of Practice “Maintaining Professional Boundaries and Preventing Sexual Abuse”.

The amended Standard contains numerous new expectations intended to ensure that both the massage therapist and the client are protected from boundary violations and sexual abuse, as well as from allegations of such conduct.

Chief among the amendments to the Standard is the requirement that each and every time an RMT treats a “sensitive area”, the RMT must obtain prior written consent from the client.

A “sensitive area” includes any one of the following: chest wall musculature, the breast, upper inner thigh, and gluteal region. According to the College, touching of the genital or anal area is never clinically indicated, and would always amount to sexual abuse of a patient.

The College requires all RMTs to obtain a signed sensitive area consent form prior to each and every instance of treatment. This applies regardless of the RMT’s level of familiarity with the client, or the frequency of the client’s treatments with the RMT. This requirement also applies regardless of the gender of the client or the RMT.

The College requires all RMTs to obtain a signed sensitive area consent form even if the need to treat such an area emerges after the client’s treatment has commenced. For instance, a client could request the treatment of a certain area in the middle of a massage, or the clinical need might become obvious only upon palpation.

Failure to abide by the amended Standard and obtain a signed sensitive area consent form could amount to an act of professional misconduct, even in the absence of any allegation of sexual abuse or other impropriety. In addition, RMTs have an independent obligation to ensure their compliance with the Standard, regardless of the practice of other RMTs or expectations of clinic management. It is important for RMTs to ensure compliance with the Standard in order to avoid negative outcomes in complaints or discipline proceedings.

The College’s stated objective behind introducing the amendments is that touching of the sensitive area “poses a potential risk for misinterpretation, misunderstanding and may be experienced by the client as a violation of their body – and possibly as sexual abuse.” In this way, obtaining a signed sensitive area consent form is intended to provide the client with additional notice and warning with respect to the touching of that area, which in theory reduces the chance of a misunderstanding. The presence of a signed sensitive area consent form could also protect the RMT against allegations of impropriety.

Here is a sample Sensitive Area consent form offered by the CMTO.